Green Channel - Vaccination
Regional Programme for Pre-Vaccination Consultancy and Vaccine Adverse Event Surveillance “Green Channel”
Modern vaccinology has led to the development of new, highly immunogenic and safe instruments against infectious diseases. However, the demand for safety has also increased, along with misinformation and hesitancy, particularly in areas where vaccine preventable diseases are uncommon. Although serious adverse events following immunization (AEFIs) are rare, it is sometimes difficult to ascertain a causal association and establish eligibility for further administration at the individual level. For this reason in 1993, the Veneto Region Public Health Authority approved a project for vaccination improvement, which established a special immunization service for prevention, clinical evaluation, and monitoring of AEFIs, named the Green Channel, at the Immunology Unit of the University Hospital of Verona.
The Green Channel has the following tasks, as assigned by the Regional Public Health Authority:
- Specialized pre-vaccination consultancy, for the Local Health Units (LHUs), to evaluate the eligibility to vaccination of subjects with history of previous AEFIs or contraindication;
- Management of the regional AEFI surveillance system;
- Monitoring of serious AEFIs reported in the Veneto Region;
- Surveillance of specific AEFIs or events of special interest (AESI);
- Publication of annual reports on activity for feedback information to vaccine personnel.
Pre- and Post-vaccination Consultancy
The consultancy is offered to physicians for subjects who need a specialized examination for suspected AEFIs or contraindications to start or continue vaccine administration. Subjects with previous AEFIs and/or underlying pathologies as potential risk factors are evaluated by record examination or direct consultation in our clinic. The consultation is requested through a standard form to be filled in and sent by e-mail.
The evaluation is based on official guidelines for contraindications to immunization and recommendations from scientific organizations. For each subject, children or adult, a conclusive report is released containing instructions for vaccination with standard procedure or precautions (i.e pre-medication, temporally separated single injections, hospitalization, different vaccine preparation), or, in selected cases, indicating temporary suspension or exemption. Outcome of recommended vaccinations is requested to the referring physicians. If vaccine administration in hospital setting is needed, Green Channel personnel organize and supervise the procedure in a Paediatrics or Intensive Care Unit.
Regional AEFI Surveillance System
The AEFI Regional Surveillance System was assigned to the Green Channel in 1993 and it has the role of supporting the national Pharmacovigilance System. The AEFI reports forwarded to the Green Channel by the regional centre for Pharmacovigilance are examined, classified and computerized into the Green Channel database. Unusual and serious cases are thoroughly studied for causality assessment and followed up to recovery or stabilization of the lesion. All AEFI reports are analyzed and calculated on the basis of administered doses of vaccines extracted from the regional computerized immunization registry. Data are summarized and discussed in annual reports.
During the overall period, 23 official reports on the consultation and surveillance activity of the Green Channel have been published in Italian for the Health Authorities and vaccine personnel of the LHUs. The 22nd and 23rd reports contain a summary in English.
The Green Channel collaborates with the Regional Public Health Authority on training programmes on vaccine safety for health care personnel.
Clinical research on vaccine safety is also conducted and several articles have been published in peer-review journals. She participated in the EAACI Position Paper for Vaccination and Allergy preparation
Head of the Programme:
Dr. Giovanna Zanoni, MD, Allergist and Clinical Immunologist, Specialist in Hygene and Public Health
Head of the Immunology Unit
Prof. Vincenzo Bronte, MD
Dr. Giovanna Zanoni, is a member of the following Committees:
- Regional Vaccination Committee, Nationale;
- National Immunization Technical Advisory Group) (NITAG);
- Scientific Committee for Covid-19 vaccine, Italian Medicine Agency;
- ENDA European Network for Drug Allergy, European Academy of Allergy and Clinical Immunology (EAACI).
Location and Contacts
Regional Public Health Authority, Veneto Region